Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS5235507 A
Publication typeGrant
Application numberUS 07/464,972
Publication dateAug 10, 1993
Filing dateJan 16, 1990
Priority dateJan 16, 1990
Fee statusPaid
Publication number07464972, 464972, US 5235507 A, US 5235507A, US-A-5235507, US5235507 A, US5235507A
InventorsArthur F. Sackler, Marshall Levin
Original AssigneeP. B. Toau And Company, Ltd.
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Health insurance management system
US 5235507 A
Abstract
Data processing for a health insurance management system verifies the insurance status of the claimant, identifies the appropriate insurance policy, calculates the amount to be paid to the health care provider, pays the provider, calculates the payment required by the claimant, if any, and debits the account of the claimant in the amount required. A claim may be processed under more than one policy where appropriate. The system can handle both individual and family insurance policies.
Images(4)
Previous page
Next page
Claims(4)
What is claimed is:
1. A health insurance management system for processing claims associated with a plurality of individual accounts and a plurality of separate plans sponsored by one or more organizations for management by an employer or participant-based management group, comprising:
means for entering claim data corresponding to one of said plurality of individual accounts;
means for verifying an insured status of said account;
means for selectively determining a plan culled from a database of discrete plans corresponding to said account, and implementing a set of plan parameters defining plan attributes for processing said claim data;
data processing means for determining the relative payment of charges associated with said claim data by said sponsoring organization, a carrier and claimant wherein relative charges are one of the parameters in said set of plan parameters and said data processing means culls from a claimant database past charges accrued during a pre-defined periodic interval;
means for checking an authorization of a health care provider in accordance with said claim data; and
means for paying the provider.
2. A system according to claim 1 further comprising means for debiting the account of the claimant.
3. A system according to claim 1 wherein said data processing means further comprises means for identifying one or more secondary policies covering the claim and means for processing the claim under said secondary policies.
4. A system according to claim 1 further comprising means for debiting the insurer's account.
Description
BACKGROUND OF THE INVENTION

This invention relates to a health insurance management system, and more particularly to a method and apparatus for processing health insurance claims using a computer program.

In the past, health insurance was almost exclusively the province of insurance companies which would issue a traditional reimbursement for services under a single set of master policy criteria. Recently, rising health care costs have driven many employers to become self-insured, leading to a proliferation of policy types, multiple coverage (accelerated by dual wage earner families) and wide variations in reimbursement and payment practices. However, self-insurers who are not in the insurance business are burdened by the administrative tasks associated with the processing of health insurance claims. This has caused the birth of a new industry devoted to assisting self-insurers in insurance-related administrative tasks. In addition to management companies specializing in this area, the insurance companies themselves have begun administering self-insurance plans for clients on a fee basis. Presently, more than half of all claims adjudicated by insurance companies (over $30 billion) were processed as the administrator of self-insured plans on a fee basis.

Management and insurance companies devoted to servicing a number of self-insurers must keep track of the different policies in effect at each client self-insurer company, the insured parties for each self-insurer, the claims filed for each individual within each client company, etc., so that when a claim is filed it can be processed correctly and efficiently. The greater the efficiency of the processing system, the greater will be the cost-effectiveness of the management company; greater cost-effectiveness in turn makes self-insurance administration more competitive relative to the services traditionally offered by the insurance companies.

As the volume of their business has increased, many insurance management companies have begun using computerized systems to more efficiently and quickly handle health insurance claims for their clients. However, the systems now in effect are of limited efficiency, in part because they require a great deal of input from human operators each time a claim is processed.

SUMMARY OF THE INVENTION

A health insurance management system is provided which includes means for entering claim data, means for verifying the insurance status of the claimant, means for identifying the appropriate insurance policy, means for calculating the amount to be paid to the health care provider, means for paying the provider, means for calculating the payment required by the claimant, if any, and means for debiting the account of the claimant.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A, 1B, 1C and 1D together illustrate the flow chart of a computer program for use in one embodiment of a system according to the present invention.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

The system of this invention preferably includes a computer program and an associated data base which supplied the necessary information to the program after the initial data input is completed. The data base typically contains information on insured individuals, on the essential provisions of the health insurance policies covering each individual, and on which health care providers are authorized to perform services under each policy.

Referring to FIGS. 1A-1D, in one embodiment of a computer program for use in a system according to the present invention the processing of a health insurance claim begins with the input of the identity of the insured individual (ID), the identity of the health care provider (PROV), the amount of the claim (AMT), the treatment provided (TRT), and whether a second opinion was obtained prior to treatment (SO). The program then compares the ID to the computer data base (DB) to see if the ID is valid; if it is not, an appropriate message is generated and processing ends. If the ID is in the data base, the PROV is then similarly checked against the DB files. If the PROV is valid, the amount (AMT) to be paid to the PROV is credited to the provider's account (BAL(PROV)). The program then fetches from the data base the insurance policy (PLAN) covering the individual.

If the ID has a spouse who is also covered (IDS), and if the patient is covered under the spouse's plan, the program fetches and compares the ages (AGE(ID)) and (AGE(IDS)) of the couple, and treats the older spouse as the patient treated (PAT) for the purpose of allocating payment amounts.

The treatment (TRT) is checked against the policy. If the TRT is not covered, a message is generated and processing under that policy ends, although, as is discussed below, the program provides for processing under another policy if one is available. If the AMT exceeds the maximum payable amount (valid TRT AMT) for this treatment (TRT) under the policy, the AMT is set equal to the valid TRT AMT and the excess is set aside for payment by the patient (PATPY).

The program checks the plan to see if a second opinion (SO) is required. If a second opinion (SO) is required and was not obtained, the claim amount (AMT) is reduced by multiplying by a fraction (X) according to the policy's provisions, and the amount of the reduction is added to the patient's co-payment amount (PATPY).

The program fetches from the DB the total claims for the past year (CLYR) for PAT and updates this amount by adding to it the AMT. If the updated CLYR is not greater than the annual deductible (DDCT) under the policy, the program searches the DB for another plan covering the PAT. An important feature of the system is its ability to handle more than one plan per individual, e.g., a primary plan and a secondary plan. If there is another plan, that plan is fetched and processed as was the primary plan. If not, the patient's account (ACCT(PAT)) is debited by the AMT plus PATPY and processing ends.

If the CLYR exceeds the DDCT, but the difference CLYR-DDCT is less than AMT, the quantity [AMT-(CLYR-DDCT)] is added to PATPY; AMT then is set equal to the difference CLYR-DDCT.

If the CLYR is greater than the co-insurance limit (LIM), the amount of co-insurance chargeable to the PAT must be calculated and added to PATPY. If the difference CLYR-LIM is greater than or equal to the AMT, the entire AMT is subject to co-insurance, and PATPY is increased by AMT times a policy-determined co-insurance fraction (Y). If this difference is less than AMT, PATPY is increased instead by the amount of the difference times the co-insurance fraction. (Under some plans, the PATPY may be increased by a policy-determined constant amount instead of a variable fraction (Y).) At this point, if PATPY is zero processing ends without debiting the patient's account (ACCT(PAT)). If PATPY is greater than zero, however, this amount is processed against any other plan(s) covering the patient before the ACCT(PAT) is debited.

Some plans have two deductibles, a family deductible and an individual deductible. In that event, both a family CLYR and an individual CLYR must be updated, each CLYR compared to its corresponding DDCT and the smallest of the two values CLYR-DDCT is used to calculate the debit amounts.

To obtain coverage, children, spouses or other dependents must be enrolled as eligible on each plan. This information will be an integral part of the DB and may be considered part of the ID.

This program is suitable where there for directly charging a patient's account, for example, by charging payments to the patient's credit card or checking account. There may be a limit to how much can be charged to the patient's account, or the patient may wish to impose such a limit, or perhaps current authorization may be lacking. The program easily may be modified to bill the patient for unchargeable amounts.

It may be desirable to debit an insurer's account for the amount of the claim minus the amount charged to the patient's account. This can be done easily. For example, after the AMT is credited to BAL(PROV), an auxiliary variable could be set equal to AMT; this auxiliary variable would be reduced by the amount charged to the patient's account and at the end of the program the reduced value would be charged to the insurer's account.

The present invention provides a method and apparatus for quickly and efficiently processing health insurance claims. Using a computerized system according to this invention, a health insurance administrator or management company may easily and automatically process a large number of health insurance claims, even where the claims fall under different insurance policies.

Many variations of the system described and illustrated are possible and will occur to those skilled in the art. For example, a policy having a separate deductible amount for each treatment, and/or having different levels of co-payment, could be easily accommodated without altering the essential nature of the invention. The exact authorization and calculation steps needed depend upon the policy in effect; a program can be tailored to fit any health insurance policy or group of policies administered together. Those skilled in the art will understand how to create the necessary programming.

With minor modifications, the present invention may also be used for processing claims for non-health related insurance, such as automobile insurance, life insurance, or property insurance, for example.

The invention is not intended to be limited to the embodiments illustrated and described herein, but encompasses all embodiments and variations of the inventive method and apparatus which are consistent with this disclosure and falling within the scope of the appended claims.

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US4491725 *Sep 29, 1982Jan 1, 1985Pritchard Lawrence EMedical insurance verification and processing system
Non-Patent Citations
Reference
1 *Data Sources, 1989, Computer Associates International, Inc., p. J 400 to J 404.
2Data Sources, 1989, Computer Associates International, Inc., p. J-400 to J-404.
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US5359509 *Oct 31, 1991Oct 25, 1994United Healthcare CorporationHealth care payment adjudication and review system
US5429506 *Apr 5, 1993Jul 4, 1995Westport Management Services, Inc.Method of computerized administration of a life insurance plan using computerized administration supervisory system
US5704044 *Jul 31, 1996Dec 30, 1997The Pharmacy Fund, Inc.Computerized healthcare accounts receivable purchasing, collections, securitization and management system
US5832447 *May 24, 1994Nov 3, 1998Envoy CorporationAutomated system and method for providing real-time verification of health insurance eligibility
US5915241 *Sep 12, 1997Jun 22, 1999Giannini; Jo MelinnaMethod and system encoding and processing alternative healthcare provider billing
US5950175 *Oct 14, 1994Sep 7, 1999Merrill Lynch, Pierce, Fenner & Smith IncorporatedSystem for managing real estate SWAP accounts
US6012035 *Oct 13, 1997Jan 4, 2000Integral Business Services, Inc.System and method for supporting delivery of health care
US6012047 *Nov 21, 1995Jan 4, 2000Transamerica CorporationReverse mortgage processing system
US6014632 *Apr 15, 1997Jan 11, 2000Financial Growth Resources, Inc.Apparatus and method for determining insurance benefit amounts based on groupings of long-term care patients with common characteristics
US6208973Feb 27, 1998Mar 27, 2001Onehealthbank.ComPoint of service third party financial management vehicle for the healthcare industry
US6341265 *Dec 3, 1998Jan 22, 2002P5 E.Health Services, Inc.Provider claim editing and settlement system
US6343271Jul 17, 1998Jan 29, 2002P5 E.Health Services, Inc.Electronic creation, submission, adjudication, and payment of health insurance claims
US6374231Oct 21, 1998Apr 16, 2002Bruce BentMoney fund banking system
US6513019Feb 16, 1999Jan 28, 2003Financial Technologies International, Inc.Financial consolidation and communication platform
US6567821 *Nov 30, 1998May 20, 2003Acs State & Local Solutions, Inc.Method and apparatus for electronic collection, translation, grouping and delivery of wage assignment information
US6735569 *Nov 4, 1999May 11, 2004Vivius, Inc.Method and system for providing a user-selected healthcare services package and healthcare services panel customized based on a user's selections
US6862573Mar 22, 2001Mar 1, 2005Clear Technology, Inc.Automated transaction management system and method
US7039593 *Aug 13, 2002May 2, 2006Robert David SagerPayment convergence system and method
US7072842 *Jan 8, 2001Jul 4, 2006P5, Inc.Payment of health care insurance claims using short-term loans
US7072909May 29, 2002Jul 4, 2006Acs State & Local Solutions, Inc.Method and apparatus for electronic collection, translation, grouping, and delivery of wage assignment information
US7194416Nov 28, 2000Mar 20, 2007P5, Inc.Interactive creation and adjudication of health care insurance claims
US7203654 *Dec 18, 2003Apr 10, 2007Dale MenendezMethod of expediting insurance claims
US7212993May 19, 2000May 1, 2007Merrill Lynch & Co., Inc.Security receipts management system
US7225155Oct 7, 1999May 29, 2007Acs State & Local Solutions, Inc.Method and apparatus for payment processing using debit-based electronic funds transfer and disbursement processing using addendum-based electronic data interchange
US7263493 *Jan 11, 2002Aug 28, 2007P5, Inc.Delivering electronic versions of supporting documents associated with an insurance claim
US7310615 *Jan 18, 2002Dec 18, 2007Goldensource CorporationFinancial data reporting system with alert notification feature and free-form searching capability
US7346522Jan 8, 2003Mar 18, 2008First Access, Inc.Medical payment system
US7346523 *Jan 11, 2002Mar 18, 2008P5, Inc.Processing an insurance claim using electronic versions of supporting documents
US7493264Jun 11, 2002Feb 17, 2009Medco Health Solutions, Inc,Method of care assessment and health management
US7509286Apr 11, 2003Mar 24, 2009Reserve Management CorporationSystems and methods for money fund banking with flexible interest allocation
US7519551Feb 8, 2002Apr 14, 2009Island Intellectual Property LlcSystems and methods for administering return sweep accounts
US7536350Mar 6, 2003May 19, 2009Island Intellectual Property LlcSystems and methods for providing enhanced account management services for multiple banks
US7552061Mar 6, 2001Jun 23, 2009Gregory RichmondMethod and system for providing prescription drug coverage
US7590557Jul 31, 2006Sep 15, 2009American Express Travel Related Services Company, Inc.Healthcare card incentive program for multiple users
US7617116Aug 3, 2001Nov 10, 2009Athenahealth, Inc.Practice management and billing automation system
US7624027Oct 24, 2003Nov 24, 2009Practice Velocity, LLCMethod and system for automated medical records processing
US7661586Nov 1, 2004Feb 16, 2010Datapath, Inc.System and method for providing a credit card with back-end payment filtering
US7664660Oct 26, 2007Feb 16, 2010Healthtrio LlcSystem for communication of health care data
US7668738Feb 27, 2001Feb 23, 2010Blue Cross And Blue Shield Of South CarolinaInsurance claim filing system and method
US7668771Jun 25, 2007Feb 23, 2010Island Intellectual Property LlcSystem and method for allocation to obtain zero activity in a selected aggregated account
US7668772Nov 14, 2008Feb 23, 2010Island Intellectual Property LlcSystems and methods for money fund banking with flexible interest allocation
US7672858Apr 26, 2007Mar 2, 2010Accretive Health, Inc.Best possible payment expected for healthcare services
US7672886Jun 10, 2005Mar 2, 2010Island Intellectual Property LlcSystems and methods for managing client accounts
US7672901Jun 25, 2007Mar 2, 2010Island Intellectual Property LlcSystem and method for holdback procedure for after-hours transactions
US7672902Jun 25, 2007Mar 2, 2010Island Intellectual Property LlcSystem and method for pre-funding interest for early termination of client account having funds in one or more aggregated accounts
US7680716Jun 25, 2007Mar 16, 2010Island Intellectual Property LlcSystem and method for allocating excess funds in aggregated control account
US7680734Nov 26, 2002Mar 16, 2010Island Intellectual Property LlcMoney fund banking system
US7685003Oct 26, 2007Mar 23, 2010Healthtrio LlcSystem for communication of health care data
US7693730Oct 26, 2007Apr 6, 2010Healthtrio LlcSystem for communication of health care data
US7716131Oct 31, 2007May 11, 2010Island Intellectual Property LlcMoney fund banking system with multiple banks and/or rates
US7720691Oct 11, 2001May 18, 2010Healthtrio LlcSystem for communication of health care data
US7720797May 23, 2006May 18, 2010Acs State & Local Solutions, Inc.Method and apparatus for electronic collection, translation, grouping, and delivery of wage assignment information
US7739195Jan 14, 2002Jun 15, 2010Acs State & Local Solutions, Inc.Apparatus and methods for providing a payment system over a network
US7752096Mar 3, 2003Jul 6, 2010Avisena, Inc.System and method for managing account receivables
US7752107Mar 21, 2007Jul 6, 2010Island Intellectual Property LlcSystem and method for managing aggregated accounts
US7752129Oct 2, 2000Jul 6, 2010Island Intellectual Property LlcSystems and methods for managing client accounts
US7752131Oct 12, 2001Jul 6, 2010Acs State & Local Solutions, Inc.Methods and apparatus for child support payment processing and child support disbursement processing
US7769604Feb 13, 2007Aug 3, 2010Health Payment Systems, Inc.System and method for managing payments for health care services
US7769688Aug 16, 2007Aug 3, 2010Island Intellectual Property LlcMoney fund banking system
US7774214Feb 13, 2007Aug 10, 2010Health Payment Systems, Inc.System and method for managing payments for health care services
US7783504Feb 13, 2007Aug 24, 2010Health Payment Systems, Inc.System and method for managing payments for health care services
US7788173Feb 28, 2003Aug 31, 2010Acs State & Local Solutions, Inc.Methods and apparatus for child support payment processing and child support disbursement processing by a processing entity
US7788296Dec 29, 2005Aug 31, 2010Guidewire Software, Inc.Method and apparatus for managing a computer-based address book for incident-related work
US7809638Oct 11, 2001Oct 5, 2010Acs State & Local Solutions, Inc.Methods and apparatus for child support payment processing and child support disbursement processing
US7809640Aug 16, 2007Oct 5, 2010Island Intellectual Property LlcMoney fund banking system
US7813940May 16, 2007Oct 12, 2010Stephen David AmbroseSystem and method for enabling health care providers to effect compensatory invoicing of patients who use a coverage entity in addition to their health insurer
US7813943Feb 13, 2007Oct 12, 2010Health Payment Systems, Inc.System and method for managing payments for health care services
US7831446Oct 26, 2007Nov 9, 2010Healthtrio LlcSystem for communication of health care data
US7856361Feb 1, 2001Dec 21, 2010Bell Yvonne FLifenet
US7860583Aug 25, 2004Dec 28, 2010Carefusion 303, Inc.System and method for dynamically adjusting patient therapy
US7877423Feb 2, 2009Jan 25, 2011Acs State And Local Solutions, Inc.Method and apparatus for electronic collection, translation, grouping, and delivery of wage assignment information
US7899689Mar 25, 2004Mar 1, 2011Vivius, Inc.Method and system for providing a user-selected healthcare services package and healthcare services panel customized based on a user's selections
US7905399May 4, 2006Mar 15, 2011Barnes Brian TLinking transaction cards with spending accounts
US7917372Mar 20, 2001Mar 29, 2011Rxeob/Com.LlcPharmacy benefits management method and apparatus
US7922083Jul 31, 2006Apr 12, 2011Harrison Sarah EPayment programs for healthcare plans
US7925518Apr 18, 2003Apr 12, 2011Visa U.S.A. Inc.System and method for payment of medical claims
US7933821Apr 10, 2009Apr 26, 2011Island Intellectual Property LlcSystems and methods for administering return sweep accounts
US7949543Feb 13, 2007May 24, 2011Oltine Acquisitions NY LLCMethods, systems, and computer program products for promoting healthcare information technologies to card members
US7949580 *Oct 18, 2000May 24, 2011Realmed CorporationPoint of service third party financial management vehicle for the healthcare industry
US7953636Feb 21, 2001May 31, 2011Genworth Financial, Inc.System and method for providing customized sales-related data over a network
US7962350Apr 18, 2005Jun 14, 2011Pps Data, LlcPayment of health care insurance claims using short-term loans
US7970626Dec 29, 2005Jun 28, 2011Oltine Acquistitions NY LLCFacilitating payments to health care providers
US7970675Feb 27, 2007Jun 28, 2011Bank Of America CorporationSecurity receipts management system
US7996308Jul 2, 2010Aug 9, 2011Island Intellectual Property LlcSystem and method for managing aggregated accounts
US8000986Jun 29, 2007Aug 16, 2011Computer Sciences CorporationClaims processing hierarchy for designee
US8010390Jun 29, 2007Aug 30, 2011Computer Sciences CorporationClaims processing of information requirements
US8010391Jun 29, 2007Aug 30, 2011Computer Sciences CorporationClaims processing hierarchy for insured
US8015111May 5, 2010Sep 6, 2011Acs State And Local Solutions, Inc.Apparatus and methods for providing a payment system over a network
US8019667Jan 7, 2010Sep 13, 2011Island Intellectual Property LlcSystems and methods for money fund banking with flexible interest allocation
US8019668Jan 13, 2010Sep 13, 2011Island Intellectual Property LlcSystem and method for allocation to obtain zero activity in a selected aggregated account with holdback
US8032396Sep 25, 2006Oct 4, 2011Aetna Inc.System and method for offering and guaranteeing renewal of suspendable healthcare benefits
US8032398Feb 13, 2009Oct 4, 2011Medco Health Solutions Inc.Care assessment tool for health management
US8032456Dec 19, 2008Oct 4, 2011Island Intellectual Property LlcSystem, methods and program products for processing for a self clearing broker dealer
US8038593Dec 6, 2004Oct 18, 2011Carefusion 303, Inc.System and method for network monitoring of multiple medical devices
US8073709May 4, 2007Dec 6, 20113M Innovative Properties CompanyCPT pricing from MedPAR data
US8099302 *Mar 16, 2011Jan 17, 2012The Trizetto Group, Inc.Method of increasing efficiency in a medical claim transaction, and computer program capable of executing same
US8121871Jan 26, 2001Feb 21, 2012Genworth Financial, Inc.System, method and software application for accessing and processing information
US8150766Dec 19, 2006Apr 3, 2012Island Intellectual Property LlcSystem and method for investing public deposits
US8160905Dec 22, 2010Apr 17, 2012The Trizetto Group, Inc.Method and apparatus for repricing a reimbursement claim against a contract
US8165944Apr 14, 2011Apr 24, 2012Realmed CorporationPoint of service third party financial management vehicle for the healthcare industry
US8175901Jun 14, 2010May 8, 2012Health Payment Systems, Inc.System and method for managing payments for health care services
US8195482Aug 12, 2011Jun 5, 2012First Access, Inc.Medical payment system
US8214230Oct 9, 2009Jul 3, 2012The Trizetto Group, Inc.Health plan management method and apparatus
US8229978Nov 29, 2010Jul 24, 2012Acs State And Local Solutions, Inc.Method and apparatus for electronic collection, translation, grouping, and delivery of wage assignment information
US8239321Jul 12, 2011Aug 7, 2012Island Intellectual Property LlcSystem and method for allocation to obtain zero activity in one or more selected aggregated deposit accounts
US8260697Jul 12, 2011Sep 4, 2012Island Intellectual Property LlcSystems and methods for money fund banking with flexible interest allocation
US8260705Dec 21, 2010Sep 4, 2012Island Intellectual Property LlcSystems, methods and program products for deposit and withdrawal processing
US8290859Mar 20, 2009Oct 16, 2012Island Intellectual Property LlcSystems and methods for providing enhanced account management services for multiple banks
US8290860Mar 20, 2009Oct 16, 2012Island Intellectual Property LlcSystems and methods for providing enhanced account management services for multiple banks
US8290861May 8, 2009Oct 16, 2012Island Intellectual Property LlcSystems and methods for providing enhanced account management services for multiple banks
US8296164Oct 14, 2010Oct 23, 2012Rxeob.Com, LlcPharmacy benefits management method and apparatus
US8311916Mar 21, 2011Nov 13, 2012Island Intellectual Property LlcSystems and methods for administering return sweep accounts
US8311939Jun 4, 2010Nov 13, 2012Island Intellectual Property LlcMethod and system for allocating deposits over a plurality of depository institutions
US8340792Nov 16, 2010Dec 25, 2012Carefusion 303, Inc.System and method for dynamically adjusting patient therapy
US8346643Mar 21, 2012Jan 1, 2013Realmed CorporationPoint of service third party financial management vehicle for the healthcare industry
US8352342Jun 15, 2010Jan 8, 2013Island Intellectual Property LlcMethod and system for determining fees for deposits allocated over a plurality of deposit institutions
US8355985Mar 20, 2009Jan 15, 2013Island Intellectual Property LlcSystems and methods for providing enhanced account management services for multiple banks
US8359267Sep 29, 2011Jan 22, 2013Island Intellectual Property LlcSystem and method for investing public deposits
US8370236Nov 23, 2010Feb 5, 2013Island Intellectual Property LlcMethod and system for allocating funds over a plurality of time deposit instruments in depository institutions
US8380621Feb 4, 2008Feb 19, 2013Island Intellectual Property LlcSystems, methods and program products for swap processing for uninsured accounts
US8386382Jun 21, 2012Feb 26, 2013Island Intellectual Property LlcSystem and method for allocation to obtain zero activity in one or more selected aggregated deposit accounts
US8386383Nov 20, 2009Feb 26, 2013Island Intellectual Property LlcMoney fund banking system with multiple banks and/or rates
US8386385Jul 27, 2011Feb 26, 2013Acs State & Local Solutions, Inc.Apparatus and methods for providing a payment system over a network
US8392326Jul 22, 2010Mar 5, 2013Acs State & Local Solutions, Inc.Method and apparatus for payment processing using debit-based electronic funds transfer and disbursement processing using addendum-based electronic data interchange
US8401962May 8, 2009Mar 19, 2013Island Intellectual Property LlcSystems and methods for providing enhanced account management services for multiple banks
US8407071Jan 18, 2012Mar 26, 2013The Trizetto Group, Inc.Method and apparatus for repricing a reimbursement claim against a contract
US8413905Oct 5, 2009Apr 9, 2013Visa U.S.A. Inc.Portable prescription transaction payment device
US8417543Jun 17, 2010Apr 9, 2013Visa U.S.A. Inc.Electronic payment delivery service
US8452702Sep 8, 2011May 28, 2013Island Intellectual Property LlcSystem, method and program product for minimizing fund movements
US8458089Feb 22, 2011Jun 4, 2013Island Intellectual Property LlcSystem, method and program product for administering fund movements using depository institution groups
US8463697Mar 23, 2007Jun 11, 2013Liberty Home Equity Solutions, Inc.Method and system for providing a loan using equity in a new home
US8494876Jan 12, 2012Jul 23, 2013The Trizetto Group, Inc.Method of increasing efficiency in a medical claim transaction, and computer program capable of executing same
US8494881Sep 9, 2004Jul 23, 2013Vivius, Inc.Method and system for providing a user-selected healthcare services package and healthcare services panel customized based on a user's selections
US8498933May 8, 2009Jul 30, 2013Island Intellectual Property LlcSystems and methods for providing enhanced account management services for multiple banks
US8515784Aug 23, 2007Aug 20, 2013Mckesson Financial HoldingsSystems and methods of processing health care claims over a network
US8521569Jan 7, 2013Aug 27, 2013Island Intellectual Property LlcMethod and system for allocating funds over a plurality of time deposit instruments in depository institutions
US8527298Jun 1, 2012Sep 3, 2013First Access, Inc.Medical payment system
US8527548Jul 23, 2012Sep 3, 2013Acs State And Local Solutions, Inc.Method and apparatus for electronic collection, translation, grouping, and delivery of wage assignment information
US8560442May 8, 2009Oct 15, 2013Island Intellectual Property LlcSystems and methods for providing enhanced account management services for multiple banks
US8560446Dec 28, 2009Oct 15, 2013Visa U.S.A. Inc.Product level payment network acquired transaction authorization
US8566200Aug 22, 2012Oct 22, 2013Island Intellectual Property LlcSystems and methods for money fund banking with flexible interest allocation
US8566201Aug 22, 2012Oct 22, 2013Island Intellectual Property LlcSystems and methods for money fund banking with flexible interest allocation
US8571960Feb 5, 2013Oct 29, 2013Island Intellectual Property LlcSystem and method for allocation to obtain zero activity in one or more selected aggregated deposit accounts
US8571984Mar 13, 2013Oct 29, 2013Island Intellectual Property LlcSystems and methods for providing enhanced account management services for multiple banks
US8583528Dec 13, 2012Nov 12, 2013Realmed CorporationPoint of service third party financial management vehicle for the healthcare industry
US8583545Sep 20, 2011Nov 12, 2013Island Intellectual Property LlcSystems and methods for money fund banking with flexible interest allocation
US8589289Feb 22, 2011Nov 19, 2013Island Intellectual Property LlcSystem, method and program product for administering fund movements
US8606594Nov 20, 2009Dec 10, 2013Practice Velocity, LLCMethod and system for automated medical records processing
US8606676Mar 15, 2013Dec 10, 2013Island Intellectual Property LlcSystem and method for allocating excess funds in control account
US8612324Oct 15, 2012Dec 17, 2013Island Intellectual Property LlcSystems and methods for administering return sweep accounts
US8626534Nov 22, 2006Jan 7, 2014Healthtrio LlcSystem for communication of health care data
US8626654Jan 31, 2013Jan 7, 2014Acs State & Local Solutions, Inc.Method and apparatus for payment processing using debit-based electronic funds transfer and disbursement processing using addendum-based electronic data interchange
US8630722Dec 4, 2012Jan 14, 2014Carefusion 303, Inc.System and method for dynamically adjusting patient therapy
US8655688May 7, 2012Feb 18, 2014Health Payment Systems, Inc.System and method for managing payments for health care services
US8655689Oct 12, 2012Feb 18, 2014Island Intellectual Property LlcSystem, method and program product for modeling fund movements
US8660855Jun 8, 2007Feb 25, 2014Visa U.S.A. Inc.System and method using extended authorization hold period
US8660862May 30, 2007Feb 25, 2014Visa U.S.A. Inc.Determination of healthcare coverage using a payment account
US8666787Dec 10, 2012Mar 4, 2014Trizetto CorporationMethod and apparatus for repricing a reimbursement claim against a contract
US8676703Apr 27, 2006Mar 18, 2014Guidewire Software, Inc.Insurance policy revisioning method and apparatus
US8688577Jul 31, 2012Apr 1, 2014Island Intellectual Property LlcSystems, methods and program products for deposit and withdrawal processing
US8688581Sep 4, 2013Apr 1, 2014Visa U.S.A. Inc.Product level payment network acquired transaction authorization
US8690772 *Nov 28, 2006Apr 8, 2014Swiss Reinsurance Company Ltd.Activation and control device for coupling two mutually activatable automatic intervention systems
US8706524Jun 28, 2012Apr 22, 2014Trizetto CorporationHealth plan management method and apparatus
US8712911Mar 15, 2013Apr 29, 2014Island Intellectual Property LlcSystem and method for investing public deposits
US8719062Mar 15, 2013May 6, 2014Island Intellectual Property LlcMethod and system for allocating funds over a plurality of time deposit instruments in depository institutions
US8719157Dec 14, 2012May 6, 2014Island Intellectual Property LlcSystem and method for investing public deposits
US8738402Feb 6, 2013May 27, 2014Trizetto CorporationMedical of increasing efficiency in a medical claim transaction, and computer program capable of executing same
US8738530Jan 24, 2013May 27, 2014Acs State & Local Solutions, Inc.Apparatus and methods for providing a payment system over a network
US8744874Apr 30, 2007Jun 3, 2014Ndchealth CorporationSystems and methods for personal medical account balance inquiries
US8756075May 18, 2011Jun 17, 2014Trizetto CorporationSystem and method for processing payment bundles
US8768729Oct 14, 2004Jul 1, 2014Trizetto CorporationSystem and method for using a first electronic representation of contract terms for generating a second electronic representation of the contract terms
US8781931Dec 15, 2009Jul 15, 2014Island Intellectual Property LlcMethod and system for allocating deposits over a plurality of depository institutions
US8788284Apr 27, 2007Jul 22, 2014Visa U.S.A. Inc.Method and system using combined healthcare-payment device and web portal for receiving patient medical information
US20100138243 *Oct 2, 2009Jun 3, 2010Payformance CorporationSystems and methods for facilitating healthcare cost remittance, adjudication, and reimbursement processes
US20100179451 *Nov 28, 2006Jul 15, 2010Swiss Reinsurance CompanyActivation and control device for coupling two mutually activatable automatic intervention systems
US20130332186 *Aug 12, 2013Dec 12, 2013Athenahealth, Inc.Methods and apparatus for healthcare payment processing
USRE43246Apr 14, 2004Mar 13, 2012Island Intellectual Property LlcMoney fund bank system
WO1995003569A2 *Jul 18, 1994Feb 2, 1995Patrick M LawlorMethod for determining primary and secondary sources of health insurance coverage
WO2000057264A1 *Mar 22, 2000Sep 28, 2000David J WeitzMedical practice management system
WO2001022338A1 *Sep 22, 2000Mar 29, 2001Pamela R MartinSystem for payment of service fees
WO2002047000A1 *May 15, 2001Jun 13, 2002Patientwise CorpSystem and method for purchasing health-related services
WO2003079142A2 *Feb 21, 2003Sep 25, 2003Regence GroupClaims clinical code editing and procedure management tool
WO2004063855A2 *Dec 31, 2003Jul 29, 2004Dale MenendezMethod of expediting insurance claims
WO2008151256A2 *Jun 4, 2008Dec 11, 2008Computer Sciences CorpMultiple policy claims processing
Classifications
U.S. Classification705/2, 705/4, 705/40
International ClassificationG06Q40/00
Cooperative ClassificationG06Q40/02, G06Q20/102, G06Q50/22, G06Q40/08
European ClassificationG06Q40/02, G06Q20/102, G06Q40/08, G06Q50/22
Legal Events
DateCodeEventDescription
Aug 10, 2005FPAYFee payment
Year of fee payment: 12
Aug 10, 2005SULPSurcharge for late payment
Year of fee payment: 11
Feb 23, 2005REMIMaintenance fee reminder mailed
Feb 9, 2001FPAYFee payment
Year of fee payment: 8
Jul 21, 1997FPAYFee payment
Year of fee payment: 4
Jul 21, 1997SULPSurcharge for late payment
Mar 18, 1997REMIMaintenance fee reminder mailed
Oct 21, 1991ASAssignment
Owner name: MED POWER, INC., NEW YORK
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:P.B. TOAU & CO., LTD.;REEL/FRAME:005880/0946
Effective date: 19911003
Mar 27, 1990ASAssignment
Owner name: P. B. TOAU AND COMPANY, LTD.,, NEW YORK
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNORS:SACKLER, ARTHUR F.;LEVIN, MARSHALL;REEL/FRAME:005267/0118
Effective date: 19900301